Individual provider Active NPI

Chris Scott Gibson, D.C.

  • Chiropractor
  • Sacramento, CA
National Provider Identifier
1689679797
Registry record updated Nov 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
23817 Issued in CA
Practice address
2906 Darwin St
Sacramento, CA 95821-4510
Phone
(916) 925-2225
Fax
(916) 925-2220
NPI assigned
Jun 15, 2005
Reactivated
Apr 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 23817 CA Primary

Addresses

Primary practice location

2906 Darwin St
Sacramento, CA 95821-4510

Mailing address

2906 Darwin St
Sacramento, CA 95821-4510
Phone (916) 925-2225

Other identifiers 1

IdentifierTypeStateIssuer
DC0238170MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041012000378 CA Practitioner - Chiropractic 9537128129 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2906 Darwin St
Sacramento, CA 95821-4510
Phone (916) 925-2225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Gibson Chiropractic Inc Chiropractor CurrentSince Aug 13, 2004 Accepting new patients

Locations

2906 Darwin St
Sacramento, CA 95821
Phone (916) 925-2225

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414972800000",
    "number": "1689679797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2906 DARWIN ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958214510",
            "telephone_number": "916-925-2225",
            "fax_number": "916-925-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2906 DARWIN ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958214510",
            "telephone_number": "916-925-2225",
            "fax_number": "916-925-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "CHRIS",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-15",
        "last_updated": "2014-11-03",
        "deactivation_date": "2006-03-18",
        "reactivation_date": "2006-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "23817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DC0238170",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.